J._Celeste_Lay

A college student whose grades in high school and scores on the ACT were so high that she obtains a full ride to LSU. An 8-year-old boy with severe disabilities whose parents are fully employed and earn good benefits. A freshman in high school whose uncle was recently shot in New Orleans. What do they have in common? They could all lose if U.S. Sens. Bill Cassidy and John Kennedy vote in favor of the Better Care Reconciliation Act.

As Louisiana senators decide whether to support this bill to “repeal and replace Obamacare,” they should consider the far-reaching effects of slashing Medicaid. Beyond the direct effects on those who are currently enrolled in Medicaid, two bills — one being considered by the Senate and the other passed by the House — will slash funding well beyond health care.

That college student who managed to get a great scholarship? If she isn’t working and comes from a poor household, under current plans, her dream of a college education is much more difficult to fulfill.

An analysis from the Center for Law and Social Policy shows that if the House bill were to pass, Louisiana would need to replace $10 billion over the next 10 years to maintain benefits for current Medicaid enrollment. Given the state’s budgetary woes, this means Louisiana will have to deny coverage, ration care, or divert funds from other programs — like higher education — to make up for the lost federal Medicaid dollars. Nationally, 5.6 million college students report incomes low enough to qualify for Medicaid. Were Louisiana to impose a work requirement for Medicaid, as some states have discussed, all those attending school on scholarships and not working could lose their health coverage. It is difficult enough for low-income college students to make it through college; losing their health insurance would only exacerbate the gaps in opportunity for poor and affluent young people.

What about the disabled kid whose parents have insurance through their employers? Since 1988, Medicaid has permitted payments to schools under the Individuals with Disabilities Education Act. Public schools rely on Medicaid for services and equipment for special-education students. These funds pay for personnel who work directly with students: school nurses, social workers, psychologists, and physical, occupational and speech therapists. Schools also depend on Medicaid for much-needed medical equipment, such as walkers and wheelchairs, for students with disabilities. Approximately 11 percent of students in Louisiana have disabilities; in 2014, 13 percent of students in the Recovery School District-New Orleans required special education accommodations.

And the young man whose uncle was recently shot? What does the health care law have to do with him? School districts use Medicaid dollars to provide health services — including mental health services — to students in poverty. In New Orleans, where children test positive for post-traumatic stress disorder at three times the national rate, these funds could be critically important.

U.S. Senate Majority Leader Mitch McConnell, R-Kentucky delayed a vote until after the July 4 recess. That should have given both senators opportunities to seriously consider the widespread effects of the bill before them. Louisiana is one of the poorest states in the country and has some of the worst outcomes for health and well-being. Beyond the health impacts, Louisiana lags behind other states in per-pupil spending and in educational outcomes.

The real beneficiaries of the House and Senate bills are the affluent. The Tax Policy Center finds that nearly 45 percent of the benefits of the tax cuts will go to the highest one percent of households, or those making more than $875,000 annually. The question before our senators is: Should these kids and other Medicaid beneficiaries suffer so the affluent can get a tax cut?

J. Celeste Lay is an associate professor of political science at Tulane University and the co-director of the New Orleans chapter of the Scholars Strategy Network.